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tion of non-pauper small-pox cases was fitted up, but I cannot say that it
was a success from an administrative point of view; and I do not think
that the proposal to create combined districts and district hospitals, with
newly constituted authorities, would be attended with success.
It appears to me that the simple course is for the Local Boards to ask
the Local Government Board to promote a Bill to enable local authorities
to send, upon adequate payment, non-pauper cases to non-pauper wards in
existing metropolitan hospitals. It cannot be too strongly urged upon the
public generally that in all cases of infectious disease, and particularly of
small-pox, that the isolation of the patient should be the first consideration;
and, whenever a patient cannot be properly isolated in his own residence, he
should be removed to a hospital. It happens occasionally that not only
does the patient object to be removed, but unfortunately the medical
practitioner in attendance on the case likewise objects, the result of which
is that the patient is kept at home, and the disease spreads far and wide in
the locality. This ought not to be, and would not occur if all persons felt
a duo regard to the public health.
It will be seen from the following resolutions which were agreed to at
a meeting of the Medical Officers of Health, which was held in the spring
of 1877, that they had considered this important subject:—
"That such provision could be best made in a comprehensive and
systematic, manner by one central authority acting for the whole metropolis,
not only for pauper patients, but for other classes desirous of hospital
accommodation."
"That such central authority should not be merely a Department of
Poor Law Administration, but should have the powers of the Sanitary Acts
conferred upon them."
"That either the Metropolitan Asylum Board should be merged into
such central authority, or should itself be that authority; in which case its
constitution should be altered and adapted to its enlarged duties and
responsibilities."
It will be seen on referring to my report for March 1877, that the
subject of providing Hospital accommodation for the reception of those
persons suffering from infectious diseases, and who are willing to pay for
the accommodation, was discussed.
Bakehouses.
In my report for the quarter ended 28th September, 1872, I directed
the attention of the Board to the general condition of the bakehouses in the